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TR-9655A
Town Hall Annex '� Glenn Goldsmith, President WXX.�, 54375 Route 25 A. Nicholas Krupski, Vice President P.O. Box 1179 XV Eric Sepenoski Southold, New York 11971 Liz Gillooly Telephone (631) 765-1892 Elizabeth Peeples Fax (631) 765-6641 Z ly N MIN BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: 9,15`22- INSPECTED BY: Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, haybale line/silt boom/silt curtain 1st day of construction 1/2 constructed Project complete, compliance inspection Flrs4- C"+I-frune- COMMENTS: USSA CERTIFICATE OF COMPLIANCE: Glenn Goldsmith,President if so Town Hall Annex Michael J.Domino,Vice-President ,`O� ®�� 54375 Route 25 P.O.Box 1179 John M.Bredemeyer III J [ Southold,New York 11971 A.Nicholas Krupski G Q Telephone(631) 765-1892 Greg Williams �� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SOUTHOLD TOWN BOARD OF TRUSTEES YQU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD QF TRUSTEES 7YHOU1tq-PRIORcTO COMMENCEMENT OF THE ACTIVITIES C1-E,KERPFF 'INSPECTION SCHEDULE Pre-constructi ireffl*We1rre3 t boh 4st day of construction % constructed X When project complete, call for'com'pliance"inspection; i Glenn Goldsmith,President QF SO(/rTown Hall Annex Michael J.Domino,Vice-President ,`O� ��� 54375 Route 25 P.O.Box 1179 John M.Bredemeyer III Southold,New York 11971 A.Nicholas Krupski G Telephone(631)765-1892 Greg Williams %�� i0 Fax(631)765-6641 COU BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 9655A Date of Receipt of Application: February 25, 2020 Applicant: G. Meyran Irrevocable Trust SCTM#: 1000-99-3-1 Project Location: 175 Soundview Avenue, Mattituck -Date of'Resolution/Issuance: July 15, 2020 - Date of Expiration: July 15, 2022 Reviewed by:, Glenn Goldsmith, President Project Description: Ten (10) year maintenance permit-to maintain the brush on the bluff-by hand pruning brush and overgrowth of vines. f=indings:' The project meets all the requirements.for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town'Code. The issuance of an, Administrative,Permit allows for the operation's as indicated on the project plan prepared by.Twin Fork Landscape Contracting, Inc., received on February 25, 2020 and stamped approved on July 15, 2020. Special Conditions: None. Inspections: Final Inspection. If the proposed activities do not meet the requirements for is of an Administrative . Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. Glenn'Goldsmith, President Board of Trustees mm JM C1Ep(EpBI JM Note: ALL SUBSURFACE STRUCTURES; UNAUTHORIZED ALTERATION OR ADDITION WATER SUPPLY, SANITARY SYSTEMS, TO THIS SURVEY IS A VIOLATION OF FEB 2020 DRAINAGE, DRYWELLS AND UTILITIES, SECTION 7209 OF THE NEW YORK STATE c10 FYE ; SHOWN ARE FROM FIELD OBSERVATIONS EDUCATION LAW. ppm -; 20�50UNDVIEW AVE �'D AND OR DATA OBTAINED FROM OTHERS. COPIES OF THIS SURVEY MAP NOT BEARING SO THE LAND SURVEYOR'S INKED SEAL OR THE EXISTENCE OF RIGHTS OF WAY EMBOSSED SEAL SHALL NOT BE CONSIDERED AND/OR EASEMENTS OF RECORD IF TO BE A VALID TRUE COPY. ISO ANY, NOT SHOWN ARE NOT GUARANTEED. GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO THE d Aoo,00 Premises known os: TITLE COMPANY, GOVERNMENTAL AGENCY AND # 175 Sound View Avenue LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTI— TUTION. GUARANTEES ARE NOT TRANSFERABLE. o3�Zo''� Area= 066 47,848 s .ft. LINA'" 1 . 10 acres �U� N fAID vo .Q -3 wlkne°e ca, /ri BECK m 0, p.BE O� LONGS R M L TOP OF 8��� ---..'�`���" t�3,� 3; c � o � +� end o � 0.14 t1 qty g w Fr � Zm cn 'V steps C> / z shawM DECK 33 / ta.d m o5 +a`+ 3.3{ y conk 2��� n fT'1 � tank -c f. NCE atnm C> on- R�S�U AC Q / 33.6 baY Pero ?g,3' pck wan �k Man walk ,ding t steps rock'N0� light� column 'o �pok lance d 0,1E 7d T� Q� -'s vto w Q � * s6fNA ` FEB 2 5 2020 19��� Survey of Property situate at Mattituck LAND SURVEYING CO Town of Southold Mintovilie@aol.com r =; Suffolk County, New York SUBDIVISIONS ° Tax Map #1000-99-03-01 LAND PLANNERS TITLE MORTGAGE SURVEYS ;e a c TOPOGRAPHIC APHIC SURVEYS <1c.ua,C5 , Scale 1 "- 30' Feb. 4. , 2020 SITE PLANS ��fi, "`" �- ' ij i t GRAPHIC SCALE JOHN MINTO, L.S. LICENSED PROFESSIONAL LAND SURVEYOR PHONE: (631) 724-4832 30 0 15 30 60 120 NEW YORK STATE LIC. NO. 49866 FAX: (631) 724-5455 _ 93 SMITHTOWN BOULEVARD SMITHTOWN, N.Y. 11787 ( IN FEET ) 1 inch = 30 ft. 47,848 sq.ft. 1.10 acres 000o ia Shaded Area for Bluff Maintenance Permit FEB 2 5 2020 sit APPROVED BY BOARD OF 'iRUSTEES TOWN OF SOUTHOLD DATE \I-V&l /5,- 202-0 L Survey of Property A.ft 0 Matfituck Town of Southold Suffolk County, New York Tax Mop #1000-99-03-01 Scale 1"= 30' Feb. 4. 2020 GRAPHIC SCALE GlennGoldsmith, aident �pS�FFO(�-Co To_wn`Hall Annex Michael J. Domino, Vii,u resident y� y 54375 Route 25 John M. Bredemeyer III a '` P.O. Box 1179 A. Nicholas Krupski o Southold, NY 11971 Greg Williams y, p!- Telephone (631) 765-1892 01 �`� Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD 11 Date/Time: 4Z2S1,222o 11=3b Completed infield by: �. �„ l�lsr►-+ Twin Fork Landscape Contracting Inc., on behalf of G. MEYRAN IRREVOCABLE TRUST requests an Administrative Permit for a Ten (10) year maintenance permit to maintain the brush on the bluff by hand pruning brush and overgrowth of vines. Located: 175 Soundview Avenue, Mattituck. SCTM#: 1000-99-3-1 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=4 Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool' (cesspool): 100 feet' 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing,Card Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission ,1 Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: OK /;n—,1s l� �anj oil . I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: J. Bredemeyer M. Domino ZG. Goldsmith N. Krupski G. Williams Other � � I � � � -/ / `I ��. � �< .� ��. ` W x '�� d r , ss w � �j^. i A � a � Y' s�a � i gyp.. ^.r° � ' i' , ./ _ i � � , �i � � � �n '� j, ,� �_- •� _ — , .'' � �,� _ s ,f,��� I�� r / � ';� 1 r . '. 1 " I 7 h' / / / , ' � ' iL 1�'_ti. � 7p� � r ��� �s �� ��a � - .` � "".' � �', ,tips f,•`: ,1 - -�_�. _, ti��_ r ,' �`` ,� ,.� 1 I 1 ,�•, b :`� � � ' f �. 1 ~' � � +t� r�4 . •,` / . �I r ,� � � � � �, � , ,�i� � � � Opp 5tr&xbw" t�-Iccn 7*/jZO e z i < T s' :sa-. .y.•rry� 4 Y 1a .'.r y{ � SSR, '��r " i�g n� y�0�: .r'T-7 a•.Y " ,t.rdbt'� .Y � ,:° °�`� S.p•�t.; -�y '9 ., J` � 4: rft!� �, :, ar ?(' ,�:~ il+..,�-� �•.� � e '..' y ��: '� ./. 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(� �,\j aw,, Go gle Maps 175 Soundview Ave MCA wC�-Nom( E yee Menituct FaM Oast' j y� 9 KW Wse4s fyeeMOUMsO W ' Go }� t}" _ Comrkroal0oc4©� s �w Map data 02020 Google 500 ft _ o . 175 Soundview Ave Mattituck, NY 11952 U O e O Directions Save Nearby Send to your Share phone Photos ♦,., 1� H- t ' j y 'l ;moo— — l rccamv >aa�e� '• yw- � I M l rrtn�H ar oFx �m o �m .v A «, esu.PeorcRrrwcsew.�waF.xcr :,.R '� r'�. P - � � PRG?EN7Y 1dAP ,tea N' sA 4M1 / � 4 77 19 O A b j 'aMcl REaFnlm 94 f I.M(c) M1♦ 95 aeNm / _ \ 1° 11 .9 19 +\ . � P / —T"UCKwaN o wsTrocr - \. 2eA 3 \T Q \ -I; 4Y 25 ZIANQ Cb SfAIEOF NEW YORK)n li zNc) »NcY: \ \0 19 20 �.'ti wrtrtucK PORrt wsrwcr �5 \• _ / \ e •P 110 \' s �]Nc�) 3 f'1° '1° r I \°�, .♦ ,4,tem ,sem �i t t.u(c) ,+ 1y PCL NO. FOR PCL NO \ SEE sES SEC. o. _ S .`��`yd• hM1 ^\�i 5 nnM1 1" t.SVc) z —mm UNE 9Nq MOTCN —� uNE —�. 1 ` .�. ()'+ apt ,9±, ♦ SM SM NO.IN �.t .r NOT)CE COUNTY OF SUFFOLK © JA SECT)ONNO R+) w, Real Property TaxSernceAgenCYC—ty �•9 nilncl ra 1000 PROPERTY MAP D OFFICE LOCATION: 030 �® MAILING ADDRESS: Town Hall Annex �® �® P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) Southold, NY 11971 ® ® Telephone: 631 765-1938 NTY, LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Glenn Goldsmith, President Town of Southold Board of Trustees From: Mark Terry, AICP ; LWRP Coordinator Date: July 7, 2020 Re: LWRP Coastal Consistency Review of G. MEYRAN IRREVOCABLE TRUST SCTM# 1000-99-3-1 G. MEYRAN IRREVOCABLE TRUST requests an Administrative Permit for a ten (10) year maintenance permit to maintain the brush on the bluff by hand pruning brush and overgrowth of vines. Located: 175 Soundview Avenue, Mattituck. SCTM#: 1000-99-3-1 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is CONSISTENT with LWRP provided the following is considered: 1. The vegetation on the bluff is integral to maintaining integrity and limiting erosion. Pruning should not result in the death of the species. Any bare areas of soil should be planted with native, drought tolerant species. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action: Cc: Damon Hagan, Assistant Town Attorney John M.Bredemeyer III,President �� Town Hall Annex 54375 Main Road Michael J.Domino,Vice-President - P.O.Box 1179 ; James F.King,Trustee Southold,New York 11971-0959 Dave Bergen,Trustee �4 Telephone(631)765-1892 Charles J.Sanders,Trusteea Fax(631) 765-6641 Coil . r ' BOARD OF TOWN TRUSTEES 'TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Application Aetland Permit Application dministrative Permit Amendment/Transfer/Extension Received Application: �eceived Fee:$ la®�0 E ompleted Application:�2:-W FEB_Incomplete: 2 3 2020 _SEQRA Classification: Type I Type II Unlisted - 1Coordination:(date sent):_ Zo i/ LWRP Consistency Assessment Fore: CAC Referral Sent:—, Date of Inspection: 7i Receipt of CAC Report: Lead Agency Determination: Technical Review: Public Hearing Held: 4/S_, Resolution: Name of Applicant: IMS�f T,41� Y12 '�� __ Mailing Address: 63 M()V 1C[S k\)E5 V A9,- , (/ VMO-t J& Phone Number: Suffolk County Tax Map Number: 1000- Property Location:_ s - 5 6U N D V 1-_Ct�p �"�C *Z 7-t/C l (provi(fe LILCO Pole#, distance to cross streets, and location) AGENT: _T_W /PJ i—dCL..iC. _.l,Al--J7 S y NIT-03c t j A . (If applicable) Address: �� �d X �0 (� , �.d/ L L �� �l q 3 Phone: —]3 -L—f 3 Hoard of Trustees Applicazion GENERAL DATA Land Area(in square feet): -7 Area Zoning: L I)VNT) Previous use of property: Intended use of property: L Dr'N 7A 1- U Covenants and Restrictions on property? Yes '0 No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? _Yes X No If"Yes",be advised this application will be reviewed by the Building Dept.prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? Yes X No If"Yes",please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? Yes _ No Does the structure(s)on property have a valid Certificate of Occupancy? k Yes No Prior permits/approvals for site improvements: Agency Date 07a -7c- � zlz61J No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? No Yes If yes,provide explanation: Project Description(use attachments if necessary): ®P21-A-t tJ Ar (0 Lf13�-u i=—� Mktt-jrw-s6e M11`K Mcmr- ovu(le,V' ►N1610d Ike +0 filafvt-f m�i -,�m-e- gieustl bLt ,prinlrk� b tl 5VV�l h t6 1-11 UA11 C f 10 6;MaCVWJ pbla�6� IN ►+h QV:-- v D Gt/ U,))fV1 Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATI®N DATA Purpose of the proposed operations: 'I+-j +6 ✓tqA-t ri�A-(n o ry1 +2e— +6 b)L)4 &Nyi +o -+ftebul L a-hot wiA-b, �4he 16* �W "-V�At rvt ABC !moo-o lr 12-e-knua IA-f VU n �rV mi 6-� id Area of wetlands on lot: square feet Percent coverage of lot: Closest distance between nearest existing structure and upland edge of wetlands: ���{- feet Closest distance between nearest proposed structure and upland edge of wetlands: (�� feet Does the project involve excavation or filling? No Yes If yes,how much material will be excavated?_ cubic yards How much material will be filled? N d i4lff_ cubic yards Depth of which material will be removed or deposited: NIA-f�-- feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: pwsh ,nod 4 �. Vn114 b� Statement of the effect,if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations(use attachments if appropriate): 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part I -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part I based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part I -Project and Sponsor Information w 7&-Ni ar. Name of Action or Project: k Project Location(describe,and attach a location map): 1-715 5c?UriC> V I f-,v\/ Nct,-V- M l-T rV((� 3 Brief Description of Proposed Action: lb NX (Z KL(J,_F= m 7j FM 8LvR_- -RU Nt NGt 1 j M 7161A7161AO &UP:T `� �Svl�/f� w L rbhtf- r j",'we-r--fv r)- 76 09iLJo-& 4 rut iii 774 i/J ,T-keEFndv D_C- Name of Applicant or Sponsor. Telephone: 9?f 1r-73 lU� f'in/vlJ����lt���/�—,E-Mail. ./I t ; Address: d P6 Q'V C) City/PO: ,` l Stade: \/ Zip Code: 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance," NO- YES- administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that ❑ may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes,list agency(s)name and permit or approval: LAI 3.a.Total acreage of the site of the proposed action? acres b.Total acreage to be physically disturbed? � acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 0 acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural(non-agriculture) ❑Industrial ❑Commercial JXResidential(suburban) El Forest ❑Agriculture El Aquatic ❑Other(specify):- ❑Parkland Page I of 4 5. is the proposed action, NO -YES N/A a. A permitted use under the zoning regulations? ❑ ❑ b.Consistent with the adopted comprehensive plan? ❑ 6. Is the proposed action consistent with the predominant character of the existing built or natural -NO YES landscape? ❑ 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify: El 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NQ I YES , b.Are public transportation service(s)available at or near the site of the proposed action? ® 0- c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? '❑ 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: LJ 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: . t� 11.Will the proposed action connect to existing wastewater utilities? a NO YES If No,describe method for providing wastewater treatment: 'y ® ❑ 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? � ❑ ' b.Is the proposed action located in an archeological sensitive area? N7 ❑ ' 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? ❑ rul b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: -ET- 14. identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: 'Shoreline ElForest ❑Agricultural/grasslands ❑Early mid-successional ❑ Wetland ❑Urban ❑Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? M ❑ 16.is the project site located in the 100 year flood plain? r4M_ NO YES 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES _ If Yes, a.Will storm water discharges flow to adjacent properties? �NO YES ❑ b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: NO OYES Page 2 of 4 18.Does the proposed action include construction or other activities that result in the impoundment of NO_ YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: ❑ 7y' 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: 20,Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: a I AFFIRM THAT THE INFORMATION PROVIDED ABOVE 1S TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE ' Applicant/sponsor name:_ W��- F Date: Signature: Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the,following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning ❑ regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? V�J 3. Will the proposed action impair the character or quality of the existing community? ful 4. Will the proposed action have an impact on the environmental characteristics that caused the �{ establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or rvi affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate D reasonably available energy conservation or renewable energy opportunities?- 7. Will the proposed action impact existing: a.public/private water supplies? b.public/private wastewater treatment utilities? El 8. Will the proposed action impair the character or quality of important historic,archaeological, ❑ architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, ❑ waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage problems? ❑- 11. Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. ; Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and cumulative impacts. a E] Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Town of Southold-Board of Trustees Name of Lead Agency Date President Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT-7]' Page 4 of 4 —dE mt R!A G N 9- --mBEING DULL'SWOR1N - IDEPoSE WAND I -T"T-rWsHE IS Tim-APPLICANT FOR THE ABOVE BESC - EI'D:FER I'i' S)"AIS➢THAT ALL STATEMENTS C�NT�dNEYD�Rk�N AlE 7iRUF T D-T,HE,REST;OF, S IS KNOWLEDGE-N D AND' ' T ArLi;: T SRR �► E IIONE Ilii T IE IN SET FIARTIEi_Iii,TICS APPLICATION AND 40' #APPROVED I�X T&E_SoUTHGA..D ToWN,t6ARb'0F TRUSTEES. ' HE' 'D'I,IC AGREES T0,119-L,D THE TOWN OF, SOUTHOLD AND TRE '. BOARD OFTR691''ES IIARI�LES,ANID FItEE'FRGNd,A1�TY AND AUL DAMAGES 'ARISING UNDER-OR S�3' EMT5IFANBCU G• 'ED.,ENT 00*P�E'�'II4G jms APPLICATION,I BY A OR$ZE THE TRUSTEES, AG3�i�fiT S),,OR REPRESENTAT1 INCE1LTDWG THE. CGNSERVATIGX•ADVISORY CouriCI4 TO ENTER•QNTO-MY PROPERTY TO INSPECT THE PREMif kS IN'CdjObNC'I ION WITH T,HIS,APPLIC.A.TIONI 3ATL'UUIII TG'A FINS INSPECT! IFURTHER T B?ARB�F TkUS'TEEStG ENTER ONT-O,MY PROPERTY AND AS;IkEQUIREI3 TO INSIT� t6IR+PLP, 10E�I6iI t� N DITI4P+T OF ANS'WETLAND OR-COASTA ROSIGAI'�PE , TISSUED BY THE BOARD OF TRUSTEES-DURING THE TERM - OF THE PEST, i; Signatxi of.Pro}irty 4ivne Sign re o Yrb rry Owner S tQRN:TC}BEF®RE IVf E THIS O - .DAA OF VM :2�}..�0• i IAN a. -kA Nbt�i Public kq Q !V" My`�. Uai a,ore stated din N$ �ew•,Yo n F saL �3 rk jr„� ,.- �w-•.,... _ — "' .- _ ,- - -.y;,-,..<,-�.a-K_..n<- ,---.^..x,:....,w,- _ .tea n.U�R,�.. � .• s -(Where`the applicant-is not the-a�2M�r) owners cifthe.riopeirty identified as SCT'M#'1040- �'^.3 �- in the'tawn of New'-York,hereby authorizes ui1',,_rQ n/AT'1-b46P , r �ff-c'. act.as my agent and handle all necessaiy;vvork'invsilved with the application'process-for permit(s)from the Southold Town Board;dfT,-Mees for This liroperly. , Y` ntt r"S_S PTi3peity d saga ti re::' 'r ;{ 4 - -_ -. ,•DAY�F` - `Wc ;.•' N :,. u Ota N, 14` ' Cf'� a: R� af" o� e - e: o U - A4I' S - Q r ttii B5' 5sl sa'' ;t Orj'` U, -0�. u" - , - - ,per D� - dl+ghn/^R'^,nYo.?mwe ,_ _ rn-n.x.,�q�m..n-....ei.•...—r..�{•t+s,tn.-=+- - _- _ ms.m^s�rty§a.� � � � � f - h `� ' aA-. rnxfvnw.aR'@«=^s.•esawr�ae,»wwmaF4"asp'-m•A�+'+�`s%ea. 2-y.u�ti�ixdc�fr✓�+_&'�+aM�wa _ "�x�'_"�'�� � - ,.4�y`�`7,„a�".ej•7.: .°„1y�e' µ`P k��. saEa`}p -ate w -».K::rv..v,;-..,�,,. _ ( J r �: , NAME Of APPLIC N:'(Chock all that apply.), Tax grievant Building Variance Trustee X Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map _ Planning Other (if"©cher,now(he activity.) Do you pc.rsofwliy for through your cumpmy,tom,sibling,parent,oc child)havo a relationship with any officer or cmployt—_ t flhs fioun nP$osRhr la? "Relationship^includes by blood,rgarriaM or btssiaess ftttrnist."Iia noxz ftrt mdZ'a=w a bn�inzss, including a perhzisMp,in which dry town officeror employee bz even a partial oWna ip of(or employment by)a cotporatron in which the towaolr=r or employee owns more than 51%of the shares YES _ NO if you ansitwed"°YES`,complete tba balance ortws form find date and sign mlizre Indicated, Name of person employed by the Town of Southold "fitic or position of tont person D=Obc the rchdonship bemeen youmif(the and ft town officer or employee.Either check the approprim line A)through D)ar Vor describe in tha spice provided. The w m officer or employ z or his or her:p=r,sibling,parent or child is(check all that apply): ' f A)the owner of grater than I!: of the shuts of the cotpomte stock of the trpplitAnt (schen the applicant is a carpmation); _ B)the lt,*or benerWal owner of any Werest in a trort-cogxHH a etmty(whea lite' applieW is not a corporation); C)in otlrtxr,director,parmv.or employee of the applicant;or D)d'tc ttctuah opplicont. DESCRIMION OF AEE A'f t0NSW Submitted this _day of Signature Frrittt Nanm dwe YAQ r ' Form TIS l I, GLENN R• ml=/fe4N i i , APPLICANUAGENUREPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM Tlte'Totvh of Southiild''s"Code of Ethics prohibits conflicts of interest orilhe nart°of town officers and cmolovees.'The!ur`nose of ,this form is'to provide information whirl►can-alert the town of possible confiic&s4Interest and 6116*jt-to take wbatever.action is. necessar,+oto avoid same. YOUR NAME: T�YV 1. M1 ►-��N f U ��' i� CNW�` ` '- //1� (La �st name,first name,griddle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone -- Coastal Erosion Approval of plat Mooring ' Exemption from plat or official map Planning Other (If"Other,name the activity.) Do you,personally(or,through your company,,`spouse,sibling,,parent,or child)-have a relationship with any q icer orcmployee: of the-Town-of Southold? "Relationship"includes-by blood,tgarriuge,or business interest.-"-Business iiter`esf,';means w� usiness, includinga partnership,in,vhich the town°officer or employee h;as even'a partiaLownership of(oreniployment,-by)a'co_rporation, in which the town ofliccr�or employee owns inbrc thatt,5%-of the shares. YES _ NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold- Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. ! The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): t A)the owner of greater than 5°!a of the shares of the corpdtate stock of_the:appliclq# (when the applicant is a co`_rpo[ation); B)the legal orbeneficial owner of any interest in a non_-corporaie.entity(*lien the applicant•is not a corporation); C)an officer;director,partner;or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this day 20J Signature Print Name' N Form TS 1 f Town of Southold LWRP CONSISTENCE'ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area(which includes all of-Southold Town). 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. -Thus;.each answer-must be-explainedin•detail, listing both supporting and nom= supporting facts. If an action cannot be certified as consistent with-the LWRP policy standards and t conditions,it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office,the Planning Department, all local libraries and the Town Clerk's office. B. DESC�R'gIPTION OF SITE AND PROPOSED ACTION SCTM# MY12A'J 6r S VOG%L P PROJECT NAME 5 The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g. capital ❑ construction,planning activity,agency regulation,land transaction) (b) Financial assistance(e.g.grant,loan,subsidy) (c) Permit,approval,license,certification: Nature and extent of action: 0, -�N A- -70 AA144011h 6x 57.7AJ0-A L Ui=i=� oma- fit, w TD >°rcur7(f Location of action: �15 5a4vl4li.,.i Site acreage: Present land use: 1 /-IL Present zoning classification: 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: W Re-I& (b) Mailing address: P d &-) Z—) �_q (c) Telephone number: Area Code( 63-1 l 77 _ —1/9 (d) Application number,if any: Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes ❑ No: If yes,which state or federal;agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure,makes beneficial use of a coastal location,and minimizes adverse effects of development. See LWRP Section III-Policies; Page 2 for evaluation criteria. ❑Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III-Policies Pages 3 through 6 for evaluation criteria ❑ YesF]- No `-tom Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria ❑ YesF]1 No Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria ❑ Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of,Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria ❑ Yes ❑ No of Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III—Policies; Pages 22 . through 32 for evaluation criteria. i Yes No Not Applicable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation-criteria. ❑ Yes ❑No Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ❑ Ycs ❑ No L Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III—Policies; Pages 38 through 46 for evaluation criteria.Ij ((�� YOO No Not Applicable Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LNVRP Section III—Policies; Pages 47 through 56 for evaluation criteria. ,0 Yes Q No Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. 0 Yes 0 No Not Applicable Attach additional sheets if necessary f Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III —Policies; Pages 62 through 65 for evaluation criteria. Yes No Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. 0 Yes 0 No Not Applicable PREPARED BYLaw TITLE [/ �� DATE 7i � N NOWN ° C - P.O. Box 460 Cutchogue, NY 11935 PH: 631-734-6643 FX- 631-734-8354 httpJ/wwjv.twinforklandscapecontracting.corn 2/24/20 To the Town Trustee's: Attached provides you with an application for a 10-year maintenance permit for 175 Soundview Ave, Mattituck. TAX MAP # 99-3-1. A site plan illustrates the area of the bluff requesting to be maintained. It is a request for the top of the bluff down to the bulkhead and the width of the lot (west to east). The Homeowner would like to maintain the overgrowth of the vines and brush by hand pruning back all overgrowth and the removal of dead debris. The site is quite difficult to stake out. Jonathan Fabb did meet with Glenn Goldsmith in January on or about the 16th to go over the area for the maintenance request. We have just marked the top of the bluff. The photos illustrate the brush that the homeowner would like to request be pruned/maintained. Please feel free to caff for any questions 516-807-2575 -Thank you, ' J= Jonathan Fabb ' FEB 2 5 2020 President ; Twin Fork Landscape Contracting, Inc.